Also indexed as: Aldesleukin, Altretamine, Asparaginase,
Bicalutamide, Bleomycin, Busulfan, Cancer Chemotherapy, Capecitabine, Carboplatin, Carmustine,
Chemotherapy Drugs, Chlorambucil, Cladribine, Cytarabine, Dactinomycin, Daunorubicin,
Diethylstilbestrol, Diethylstilbestrol, Diethylstilbestrol, Doxorubicin, Estramustine,
Etoposide, Floxuridine, Fludarabine, Flutamide, Goserelin, Hydroxyurea, Idarubicin,
Ifosfamide, Irinotecan, Leuprolide, Levamisole, Lomustine, Mechlorethamine, Megestrol,
Melphalan, Mercaptopurine, Mitomycin, Mitotane, Mitoxantrone, Nilutamide, Pentostatin,
Pipobroman, Plicamycin, Procarbazine, Stilphostrol, Streptozocin, Tabloid, Teniposde, Teslac,
Testolactone, Thioguanine, Thiotepa, Toremifene, Uracil Mustard, Vercyte, Vinblastine,
Chemotherapy typically involves the use of several antineoplastic (anticancer) drugs to
treat cancer, though some people are treated
with single medications. While the drugs in this family are toxic to cancer cells, many are
also toxic to healthy cells, which gives rise to numerous side effects. A few drugs used in
chemotherapy enhance immune function, while some alter hormonal activity. One anticancer drug,
methotrexate, is also used to treat severe
cases of rheumatoid arthritis. For
interactions involving specific anticancer drugs, refer to the highlighted medications listed
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
| May Be Beneficial: Depletion or
interference—The medication may deplete or interfere with the absorption or
function of the nutrient. Taking these nutrients may help replenish them.
Multiple nutrients (malabsorption)
| May Be Beneficial: Side effect
reduction/prevention—Taking these supplements may help reduce the likelihood and/or
severity of a potential side effect caused by the medication.
Beta-carotene (mouth sores)*
Chamomile (mouth sores)
Eleuthero (see text)
Glutamine (mouth sores)
Melatonin (see text)
N-acetyl cysteine (NAC)
Spleen peptide extract (see text)
Thymus peptides (see text)
Vitamin E, topical (mouth sores)
Zinc (taste alterations)
| May Be Beneficial: Supportive
interaction—Taking these supplements may support or otherwise help your medication
Avoid: Reduced drug absorption/bioavailability—Avoid these supplements
when taking this medication since the supplement may decrease the absorption and/or activity
of the medication in the body.
St. John's wort
Avoid: Adverse interaction—Avoid these supplements when taking this
medication because taking them together may cause undesirable or dangerous results.
See Methotrexate (Folic acid)
Check: Other—Before taking any of these supplements or eating any of
these foods with your medication, read this article in full for details.
|>Interactions common to many, if not all,
Chemotherapy drugs are described in this article. Interactions reported for only one or
several drugs in this class may not be listed in this article. Some drugs listed in this
article are linked to articles specific to that respective drug; please refer to those
individual drug articles. The information in this article may not necessarily apply to drugs
in this class for which no separate article exists. If you are taking a Chemotherapy drug for
which no separate article exists, talk with your doctor or pharmacist.
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
- Busulfan (Myleran®)
- Carboplatin (Paraplatin® for Injection)
- Carmustine (BiCNU® for Injection)
- Chlorambucil (Leukeran®)
- Cisplatin (Platinol®,
- Cyclophosphamide (Cytoxan®,
- Ifosfamide (Ifex® for Injection)
- Lomustine (CeeNu®)
- Mechlorethamine (Mustargen® for Injection)
- Melphalan (Alkeran®)
- Pipobroman (Vercyte®)
- Polifeprosan 20 with Carmustine (Gliadel® Wafer)
- Streptozocin (Zanosar® for Injection)
- Thiotepa (Thioplex® for Injection)
- Uracil Mustard
- Bleomycin (Blenoxane®)
- Dactinomycin (Cosmegen® for Injection)
- Daunorubicin (Cerubidine® for Injection, DaunoXome® Injection)
- Doxorubicin (Adriamycin® Injection, Rubex® for Injection, Doxil®
- Idarubicin (Idamycin®)
- Mitomycin (Mutamycin® for Injection)
- Mitoxantrone (Novantrone® Injection)
- Pentostatin (Nipent®)
- Plicamycin (Mithracin®)
- Capecitabine (Xeloda®)
- Cladribine (Leustatin® Injection)
- Cytarabine (Cytosar-U® for Injection, Tarabine PFS® Injection, DepoCyt®
- Floxuridine (FUDR® for Injection)
- Fludarabine (Fludara® for Injection)
- Fluorouracil (Adrucil® for Injection,
- Mercaptopurine (Purinethol®)
- Methotrexate (Folex® for Injection,
- Thioguanine (Tabloid®)
- Anastrozole (Arimidex®)
- Bicalutamide (Casodex®)
- Diethylstilbestrol (Stilphostrol®)
- Estramustine (Emcyt®)
- Flutamide (Eulexin®)
- Goserelin (Zoladex®)
- Leuprolide (Lupron® Injection)
- Megestrol (Megace®)
- Nilutamide (Nilandron®)
- Tamoxifen (Nolvadex®)
- Testolactone (Teslac®)
- Toremifene (Fareston®)
- Etoposide (VePesid®)
- Teniposde (Vumon® Injection)
- Vinblastine (Alkaban-AQ® Injection,Velban® for Injection, Velsar® for
- Vincristine (Oncovin® Injection, Vincasar PFS® Injection)
- Aldesleukin (Proleukin® for Injection)
- Levamisole (Ergamisol®)
- Altretamine (Hexalen®)
- Asparaginase (Elspar®)
- Docetaxel (Taxotere® for
- Hydroxyurea (Hydrea®)
- Interferon alpha (Roferon-A®
Injection, Intron A® for Injection, Alferon N® Injection)
- Mitotane (Lysodren®)
- Paclitaxel (Paxene®,
- Procarbazine (Matulane®)
Interactions with Dietary Supplements
Chemotherapy can injure cancer cells by creating oxidative damage. As a result, some
oncologists recommend that patients avoid supplementing antioxidants if they are undergoing
chemotherapy. Limited test tube research occasionally does support the idea that an
antioxidant can interfere with oxidative damage to cancer cells.1 However, most
scientific research does not support this supposition.
A modified form of vitamin A has been
reported to work synergistically with chemotherapy in test tube research.2 Vitamin C appears to increase the effectiveness of
chemotherapy in animals3 and with human breast cancer cells in test tube
research.4 In a double-blind study, Japanese researchers found that the combination
of vitamin E, vitamin C, and N-acetyl cysteine (NAC)—all
antioxidants—protected against chemotherapy-induced heart damage without interfering
with the action of the chemotherapy.5
A comprehensive review of antioxidants and chemotherapy leaves open the question of whether
supplemental antioxidants definitely help people with chemotherapy side effects, but it
clearly shows that antioxidants need not be avoided for fear that the actions of chemotherapy
are interfered with.6 Although research remains incomplete, the idea that people
taking chemotherapy should avoid antioxidants is not supported by scientific research.
A new formulation of selenium
(Seleno-Kappacarrageenan) was found to reduce kidney damage and white blood
cell–lowering effects of cisplatin in
one human study. However, the level used in this study (4,000 mcg per day) is potentially
toxic and should only be used under the supervision of a doctor.7
Glutathione, the main antioxidant found
within cells, is frequently depleted in individuals on chemotherapy and/or radiation.
Preliminary studies have found that intravenously injected glutathione may decrease some of
the adverse effects of chemotherapy and radiation, such as diarrhea.8
Though cancer cells use glutamine as a fuel source, studies in humans have not found that
glutamine stimulates growth of cancers in people taking chemotherapy.9
10 In fact, animal studies show that glutamine may actually decrease tumor growth while
increasing susceptibility of cancer cells to radiation and chemotherapy,11
12 though such effects have not yet been studied in humans.
Glutamine has successfully reduced chemotherapy-induced mouth sores. In one trial, people
were given 4 grams of glutamine in an oral rinse, which was swished around the mouth and then
swallowed twice per day.13 Thirteen of fourteen people in the study had fewer days
with mouth sores as a result. These excellent results have been duplicated in
some,14 but not all,15 double-blind research. In another study, patients
receiving high-dose paclitaxel and melphalan
had significantly fewer episodes of oral ulcers and bleeding when they took 6 grams of
glutamine four times daily along with the chemotherapy.16
One double-blind trial suggested that 6 grams of glutamine taken three times per day can
decrease diarrhea caused by
chemotherapy.17 However, other studies using higher amounts or intravenous
glutamine have not reported this effect.18 19
Intravenous use of glutamine in people undergoing bone marrow transplants, a procedure
sometimes used to allow very high amounts of chemotherapy to be used, has led to reduced
hospital stays, leading to a savings of over $21,000 for each patient given
Magnesium and Potassium
Some chemotherapy drugs (e.g., cisplatin) may cause excessive loss of magnesium and potassium
in the urine.21 Three case reports and one review article suggest that both
potassium and magnesium supplementation may be necessary to increase low potassium
levels.22 23 In one case report, a 32-year-old man with testicular
cancer developed severe magnesium deficiency after receiving cisplatin therapy for nine
weeks.24 The magnesium deficiency resulted in seizures that were corrected by a
combination of injected and oral magnesium therapy. Magnesium deficiency, as seen in this
case, is a potentially dangerous medical condition that should only be treated by a
High amounts of melatonin have been combined with a variety of chemotherapy drugs to reduce
their side effects or improve drug efficacy. One study gave melatonin at night in combination
with the drug triptorelin to men with metastatic prostate cancer.25 All of these
men had previously become unresponsive to triptorelin. The combination decreased PSA
levels—a marker of prostate cancer progression—in eight of fourteen patients,
decreased some side effects of triptorelin, and helped nine of fourteen to live longer than
one year. The outcome of this preliminary study suggests that melatonin may improve the
efficacy of triptorelin even after the drug has apparently lost effectiveness.
NAC, an amino acid–like supplement that possesses antioxidant activity, has been used in four human
studies to decrease the kidney and bladder toxicity of the chemotherapy drug
ifosfamide.26 27 28 29 These studies used
1–2 grams NAC four times per day. There was no sign that NAC interfered with the
efficacy of ifosfamide in any of these studies. Intakes of NAC over 4 grams per day may cause
nausea and vomiting.
The newer anti-nausea drugs prescribed for people taking chemotherapy lead to greatly
reduced nausea and vomiting for most people. Nonetheless, these drugs often do not totally
eliminate all nausea. Natural substances used to reduce nausea should not be used instead of
prescription anti-nausea drugs. Rather, under the guidance of a doctor, they should be added
to those drugs if needed. At least one trial suggests that NAC, at 1,800 mg per day, may
reduce nausea and vomiting caused by chemotherapy.30
Patients with inoperable head and neck cancer were treated with a spleen peptide preparation
(Polyerga®) in a double-blind trial during chemotherapy with cisplatin and
5-FU.31 The spleen preparation had a significant stabilizing effect on certain
white blood cells. People taking it also experienced stabilized body weight and a reduction in
the fatigue and inertia that usually accompany this combination of chemotherapy agents.
Chemotherapy frequently causes mouth sores. In one trial, people were given approximately
400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an
additional four weeks.32 Those taking beta-carotene still suffered mouth sores, but
the mouth sores developed later and tended to be less severe than mouth sores that formed in
people receiving the same chemotherapy without beta-carotene.
In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E
directly to their mouth sores had complete resolution of the sores compared with one of nine
patients who applied placebo.33 Others have confirmed the potential for vitamin E
to help people with chemotherapy-induced mouth sores.34 Applying vitamin E only
once per day was helpful to only some groups of patients in another trial,35 and
not all studies have found vitamin E to be effective.36 Until more is known, if
vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be
applied topically twice per day and should probably be in the tocopherol (versus tocopheryl)
A controlled French trial reported that when postmenopausal late-stage breast cancer patients
were given very large amounts of vitamin A (350,000–500,000 IU per day) along with
chemotherapy, remission rates were significantly better than when the chemotherapy was not
accompanied by vitamin A.37 Similar results were not found in premenopausal women.
The large amounts of vitamin A used in the study are toxic and require clinical
Irradiation treatment, especially of head and neck cancers, frequently results in changes to
normal taste sensation.38 39 Zinc supplementation may be protective
against taste alterations caused or exacerbated by irradiation. A double-blind trial found
that 45 mg of zinc sulfate three times daily reduced the alteration of taste sensation during
radiation treatment and led to significantly greater recovery of taste sensation after
treatment was concluded.40
Many chemotherapy drugs can cause diarrhea,
lack of appetite, vomiting, and damage to the gastrointestinal tract. Recent anti-nausea
prescription medications are often effective. Nonetheless, nutritional deficiencies still
occur.41 It makes sense for people undergoing chemotherapy to take a high-potency
multivitamin-mineral to protect against deficiencies.
Taurine has been shown to be depleted in people taking chemotherapy.42 It remains
unclear how important this effect is or if people taking chemotherapy should take taurine
In a preliminary study, supplementation with 2 grams of L-carnitine twice a day for seven days
relieved chemotherapy-induced fatigue in 90% of people who had been treated with the
chemotherapy drugs cisplatin or ifosfamide.43 However, because there was no placebo
group in the study, one cannot rule out the possibility that the fatigue resolved
Peptides or short proteins derived from the thymus gland, an important immune organ, have been
used in conjunction with chemotherapy drugs for people with cancer. One study using thymosin
fraction V in combination with chemotherapy, compared with chemotherapy alone, found
significantly longer survival times in the thymosin fraction V group.44 A related
substance, thymostimulin, decreased some side effects of chemotherapy and increased survival
time compared with chemotherapy alone.45 A third product, thymic extract TP1, was
shown to improve immune function in people treated with chemotherapy compared with effects of
chemotherapy alone.46 Thymic peptides need to be administered by injection. People
interested in their combined use with chemotherapy should consult a doctor.
Interactions with Herbs
Echinacea (Echinacea purpurea, Echinacea angustifolia)
Echinacea is a popular immune-boosting herb that has been investigated for use with
chemotherapy. One study investigated the actions of cyclophosphamide, echinacea, and thymus gland extracts to treat advanced cancer
patients. Although small and uncontrolled, this trial suggested that the combination modestly
extended the life span of some patients with inoperable cancers.47 Signs of
restoration of immune function were seen in
Eleuthero (Eleutherococcus senticosus)
Russian research has looked at using eleuthero with chemotherapy. One study of patients with
melanoma found that chemotherapy was less toxic when eleuthero was given simultaneously.
Similarly, women with inoperable breast cancer given eleuthero were reported to tolerate more
chemotherapy.48 Eleuthero treatment was also associated with improved immune function in women with breast cancer treated
with chemotherapy and radiation.49
thistle (Silybum marianum)
Milk thistle’s major flavonoids, known collectively as silymarin, have shown synergistic
actions with the chemotherapy drugs cisplatin
and doxorubicin (Adriamycin®) in test
tubes.50 Silymarin also offsets the kidney toxicity of cisplatin in
animals.51 Silymarin has not yet been studied in humans treated with cisplatin.
There is some evidence that silymarin may not interfere with some chemotherapy in humans with
Ginger can be helpful in alleviating nausea and vomiting caused by chemotherapy.53
54 Ginger, as tablets, capsules, or liquid herbal extracts, can be taken in 500 mg
amounts every two or three hours, for a total of 1 gram per day.
German chamomile (Matricaria recutita)
A liquid preparation of German chamomile has been shown to reduce the incidence of mouth sores
in people receiving radiation and systemic chemotherapy treatment in an uncontrolled study.
When 15 drops of chamomile liquid was taken in 100 mL of warm water at least three times
daily, the radiation amount required to produce mouth sores doubled, and their overall
incidence and severity decreased.55
PSK (Coriolus versicolor)
The mushroom Coriolus versicolor contains an immune-stimulating substance called
polysaccharide krestin, or PSK. PSK has been shown in several studies to help cancer patients
undergoing chemotherapy. One study involved women with estrogen receptor-negative breast
cancer. PSK combined with chemotherapy significantly prolonged survival time compared with
chemotherapy alone.56 Another study followed women with breast cancer who were
given chemotherapy with or without PSK. The PSK-plus-chemotherapy group had a 25% better
chance of survival after ten years compared with those taking chemotherapy without
PSK.57 Another study investigated people who had surgically removed colon cancer.
They were given chemotherapy with or without PSK. Those given PSK had a longer disease-free
period and longer survival time.58 Three grams of PSK were taken orally each day in
Although PSK is rarely available in the United States, hot-water extract products made from
Coriolus versicolor mushrooms are available. These products may have activity related
to that of PSK, but their use with chemotherapy has not been studied.
Administration of St. John’s wort has
been shown to reduce blood levels of the active form of the anticancer drug
irinotecan.59 Consequently, individuals taking irinotecan should not take St.
Interactions with Foods and Other Compounds
Often, people who undergo chemotherapy develop aversions to certain foods, sometimes making it
permanently difficult to eat those foods. Exposing people to what researchers have called a
“scapegoat stimulus” just before the administration of chemotherapy can direct the
food aversion to the “scapegoat” food instead of more important parts of the diet.
In one trial, fruit drinks administered just before chemotherapy were most effective in
protecting against aversions to other foods.60
Ingestion of grapefruit juice along with etoposide has been found to reduce blood levels of
the drug.61 Studies with certain other medications suggest that grapefruit juice
may affect drug availability, even if it is consumed at a different time of the day.
Therefore, individuals taking etoposide should probably avoid grapefruit and grapefruit
1. Witenberg B, Kalir HH, Raviv Z, et al. Inhibition by ascorbic acid of
apoptosis induced by oxidative stress in HL-60 myeloid leukemia cells. Biochem
2. Sacks PG, Harris D, Chou T-C. Modulation of growth and proliferation
in squamous cell carcinoma by retinoic acid: A rationale for combination therapy with
chemotherapeutic agents. Int J Cancer 1995;61:409–15.
3. Taper HS et al. Non-toxic potentiation of cancer chemotherapy by
combined C and K3 vitamin pre-treatment. Int J Cancer 1987;40:575–9.
4. Kurbacher CM, Wagner U, Kolster B, et al. Ascorbic acid (vitamin C)
improves the antineoplastic activity of doxorubicin, cisplatin, and paclitaxel in human breast
carcinoma cells in vitro. Cancer Letters 1996:103–19.
5. Wagdi P, Fluri M, Aeschbacher B, et al. Cardioprotection in patients
undergoing chemo- and/or radiotherapy for neoplastic disease. Jpn Heart J
6. Weijl NI, Cleton FJ, Osanto S. Free radicals and antioxidants in
chemotherapy-induced toxicity. Cancer Treatment Rev 1997;23:209–40
7. Hu Y-J, Chen Y, Zhang Y-Q, et al. The protective role of selenium on
the toxicity of cisplatin-contained chemotherapy regimen in cancer patients. Biol Trace
Elem Res 1997;56:331–41.
8. De Maria D, Falchi AM, Venturino P. Adjuvant radiotherapy of the
pelvis with or without reduced glutathione: a randomized trial in patients operated on for
endometrial cancer. Tumori 1992;78:374–6.
9. Bozzetti F, Biganzoli L, Gavazzi C, et al. Glutamine supplementation
in cancer patients receiving chemotherapy: A double-blind randomized study Nutr
10. van Zaanen HCT, van der Lelie H, Timmer JG, et al. Parenteral
glutamine dipeptide supplementation does not ameliorate chemotherapy-induced toxicity.
11. Klimberg VS, McClellan JL. Glutamine, cancer, and its therapy. Am
J Surg 1996;172:418–24.
12. Souba WW. Glutamine and cancer. Ann Surg
13. Skubitz KM, Anderson PM. Oral glutamine to prevent chemotherapy
induced stomatitis: a pilot study. J Lab Clin Med 1996;127:223–8.
14. Anderson PM, Schroeder G, Skubitz KM. Oral glutamine reduces the
duration and severity of stomatitis after cytotoxic cancer chemotherapy. Cancer
15. Okuno SH, Woodhouse CO, Loprinzi CL, et al. Phase III controlled
evaluation of glutamine for decreasing stomatitis in patients receiving fluorouracil
(5-FU)-based chemotherapy. Am J Clin Oncol 1999;22:258–61.
16. Cockerham MB, Weinberger BB, Lerchie SB. Oral glutamine for the
prevention of oral mucositis associated with high-dose paclitaxel and melphalan for autologous
bone marrow transplantation. Ann Pharmacother 2000;34:300–3.
17. Muscaritoli M, Micozzi A, Conversano L, et al. Oral glutamine in the
prevention of chemotherapy-induced gastrointestinal toxicity Eur J Cancer
18. Bozzetti F, Biganzoli L, Gavazzi C, et al. Glutamine supplementation
in cancer patients receiving chemotherapy: A double-blind randomized study Nutr
19. Van Zaanen HCT, van der Lelie H, Timmer JG, et al. Parenteral
glutamine dipeptide supplementation does not ameliorate chemotherapy-induced toxicity.
20. MacBurney M, Young LS, Ziegler TR, Wilmore DW. A cost-evaluation of
Glutamine-supplemented parenteral nutrition in adult bone marrow transplant patients. J Am
Dietet Assoc 1994;94:1263–6.
21. Buckley JE, Clark VL, Meyer TJ, Pearlman NW. Hypomagnesemia after
cisplatin combination chemotherapy. Arch Intern Med 1984;144:2347.
22. Rodriguez M et al. Refractory potassium repletion due to
Cisplatin-induced magnesium depletion. Arch Intern Med 1989;149:2592–4.
23. Whang R, Whang DD, Ryan MP. Refractory potassium repletion. A
consequence of magnesium deficiency. Arch Intern Med 1992;152(1):40–5.
24. van de Loosdrecht AA, Gietema JA, van der Graaf WT. Seizures in a
patient with disseminated testicular cancer due to cisplatin-induced hypomagnesaemia. Acta
25. Lissoni P, Cazzaniga M, Tancini G, et al. Reversal of clinical
resistance to LHRH analogue in metastatic prostate cancer by the pineal hormone melatonin:
Efficacy of LHRH analogue plus melatonin in patients progressing on LHRH analogue alone.
Eur Urol 1997;31:178–81.
26. Holoya PY, Duelge J, Hansen RM, et al. Prophylaxis of ifosfamide
toxicity with oral acetylcysteine. Sem Oncol 1983;10(suppl 1):66–71.
27. Slavik M, Saiers JH. Phase I clinical study of acetylcysteine’s
preventing ifosfamide-induced hematuria. Sem Oncol 1983;10(suppl 1):62–5.
28. Loehrer PJ, Williams SD, Einhorn LH. N-Acetylcysteine and ifosfamide
in the treatment of unresectable pancreatic adenocarcinoma and refractory testicular cancer.
Sem Oncol 1983;10(suppl 1):72–5.
29. Morgan LR, Donley PJ, Harrison EF. The control of ifosfamide induced
hematuria with N-acetylcysteine. Proc Am Assoc Cancer Res 1981;22:190.
30. De Blasio F et al. N-acetyl cysteine (NAC) in preventing nausea and
vomiting induced by chemotherapy in patients suffering from inoperable non small cell lung
cancer (NSCLC). Chest 1996;110(4, Suppl):103S.
31. Borghardt J, Rosien B, Gortelmeyer R, et al. Effects of a spleen
peptide preparation as supportive therapy in inoperable head and neck cancer patients.
32. Mills EED. The modifying effect of beta-carotene on radiation and
chemotherapy induced oral mucositis. Brit J Cancer 1988;57:416–7.
33. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment
of chemotherapy-induced mucositis. Am J Med 1992;92:481–4.
34. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with
vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern
35. Lopez I, Goudou C, Ribrag V, et al. Traitement des mucites par la
vitamine E lors de l’administration d’anti-neoplasiques neutropeniants. Ann
Med Interne 1994;145:405–8.
36. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic
investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad
37. Israel L, Hajji O, Grefft-Alami A, et al. Agumentation par la
vitamine A des effets de la chimiotherapie dans les cancers du sein metastases apres la
menopause. Ann Med Interne 1985;136:551–4.
38. Henkin RI. Prevention and treatment of hypogeusia due to head and
neck irradiation. JAMA 1972;220:870–1.
39. Mossman KL, Henkin RI. Radiation-induced changes in taste acuity in
cancer patients. Int J Radiat Oncol Biol Phys 1978;4:663–70.
40. Ripamonti C, Zecca E, Brunelli C, et al. A randomized, controlled
clinical trial to evaluate the effects of zinc sulfate on cancer patients with taste
alterations caused by head and neck irradiation. Cancer 1998;82:1938–45.
41. Dreizen S et al. Nutritional deficiencies in patients receiving
cancer chemotherapy. Postgrad Med 1990;87(1):163–70.
42. Desai TK, Maliakkal J, Kinzie JL, et al. Taurine deficiency after
intensive chemotherapy and/or radiation. Am J Clin Nutr 1992;55:708–11.
43. Graziano F, Bisonni R, Catalano V, et al. Potential role of
levocarnitine supplementation for the treatment of chemotherapy-induced fatigue in non-anaemic
cancer patients. Br J Cancer 2002;86:1854–7.
44. Cohen MH, Chretien PB, Ihde DC, et al. Thymosin fraction V and
intensive combination chemotherapy. Prolonging the survival of patients with small-cell lung
cancer. JAMA 1979;241:1813–5.
45. Macchiarini P, Danesi R, Del Tacca M, Angeletti CA. Effects of
thymostimulin on chemotherapy-induced toxicity and long-term survival in small cell lung
cancer patients. Anticancer Res 1989;9:193–6.
46. Shoham J, Theodor E, Brenner HJ, et al. Enhancement of the immune
system of chemotherapy-treated cancer patients by simultaneous treatment with thymic extract,
TP-1. Cancer Immunol Immunother 1980;9:173–80.
47. Lersch C, Zeuner M, Bauer A, et al. Nonspecific immunostimulation
with low doses of cyclophosphamide (LDCY), thymostimulin, and Echinacea purpurea
extracts (Echinacin) in patients with far advanced colorectal cancers: Preliminary results.
Cancer Invest 1992;10:343–8.
48. Kupin VJ. Eleutherococcus and Other Biologically Active Modifiers
in Oncology. Moscow: Medexport, 1984, 21.
49. Kupin VI, Polevaya YB, Sorokin AM. Eleutherococcus extract treatment
for immunostimulation in cancer patients. Vopr Onkol 1986;32:21–6 [in
50. Scambia G, De Vincenzo R, Ranelletti FO, et al. Antiproliferative
effect of silybin on gynaecological malignancies: Synergism with cisplatin and doxorubicin.
Eur J Cancer 1996;32A:877–82.
51. Gaedeke J, Fels LM, Bokemeyer C, et al. Cisplatin nephrotoxicity and
protection by silibinin. Nephrol Dial Transplant 1996;11:55–62.
52. Invernizzi R, Bernuzzi S, Ciani D, Ascari E. Silymarine during
maintenance therapy of acute promyelocytic leukemia. Haemotologia
53. Meyer K, Schwartz J, Crater D, Keyes B. Zingiber officinale (ginger)
used to prevent 8-Mop associated nausea. Dermatol Nurs 1995;7:242–4.
54. Pace JC. Oral ingestion of encapsulated ginger and reported self care
actions for the relief of chemotherapy-associated nausea and vomiting. Dissertaion Abstr
55. Carl W, Emrich LS. Management of oral mucositis during local
radiation and systemic chemotherapy: A study of 98 patients. J Prosthet Dent
56. Toi M, Hattori T, Akagi M, et al. Randomized adjuvant trial to
evaluate the addition of tamoxifen and PSK to chemotherapy in patients with primary breast
cancer. Cancer 1992;70:2475–83.
57. Iino Y, Yokoe T, Maemura M, et al. Immunochemotherapies
versus chemotherapy as adjuvant treatment after curative resection of operable breast
cancer. Anticancer Res 1995;15:2907–12.
58. Mitomi T, Tsuchiya S, Iijima N, et al. Randomized, controlled study
on adjuvant immunochemotherapy with PSK in curatively resected colorectal cancer. The
Cooperative Study Group of Surgical Adjuvant Immunochemotherapy for Cancer of Colon and Rectum
(Kanagawa). Dis Colon Rectum 1992;35:123–30.
59. Mathijssen RH, Verweij J, de Bruijn P, et al. Effects of St. John's
wort on irinotecan metabolism. J Natl Cancer Inst 2002;94:1247–9.
60. Mattes RD. Prevention of food aversions in cancer patients during
treatment. Nutr Cancer 1994;21:13–24.
61. Reif S, Nicolson MC, Bisset D, et al. Effect of grapefruit juice
intake on etoposide bioavailability. Eur J Clin Pharmacol 2002;58:491–4.